Diabetes Prevention Program Lifestyle Balance
|
|
- Everett Mathews
- 5 years ago
- Views:
Transcription
1 The Diabetes Prevention Program Outcomes Study Diabetes Prevention Program Lifestyle Balance By Mary Hoskin MS, RD on behalf of The DPPOS Research Group
2 Today s Topics What was the DPP/DPPOS? What do we know from the DPP/DPPOS? What was the DPP/DPPOS Lifestyle Balance? What were the Keys to Success?
3 DPP Primary Goals To prevent or slow the development of type 2 diabetes in persons with impaired glucose tolerance (IGT) Prevention of diabetes complications such as kidney, eye and nerve problems, and heart disease DPPOS Primary Goals Continue to evaluate the effects of active interventions Microvascular and microvascular events
4 Diabetes Prevention Program Clinics
5 Study Timeline
6 Study Interventions Eligible participants Randomized Standard lifestyle recommendations Intensive Metformin Placebo Lifestyle (n = 1079) (n = 1073) (n = 1082)
7 Diabetes Prevention Program 3,234 Participants at risk for diabetes (Impaired glucose tolerance) Age 25 and older All ethnic groups Male and Female Overweight (BMI >24) Diabetes assessed by OGTT and FBG
8 DPP Screening and Recruitment Number of DPP participants Step 1 screening Step 2 OGTT Step 3 start run-in Step 3 end run-in Step 4 randomization 158,177 30,985 4,719 4,080 3,819* *3,234 in 3- arm study (585 in troglitazone arm)
9 Retention and Adherence 99.6% of the study cohort alive at end of DPP 93% completed DPP 93% of DPP annual visits completed 86% joined DPPOS ~90% of DPPOS cohort active in a given year Trivial permanent loss to follow-up Those who miss visits for 1 year, usually recaptured next year High rate of procedure completion (>98%) at all visits
10 Intervention Medications: Metformin- 850 mg per day escalating after 4 weeks to 850 mg twice per day Placebo- Metformin placebo adjusted in parallel with active drugs
11 Lifestyle Intervention An intensive program with the following specific goals: > 7% loss of body weight and maintenance of weight loss Dietary fat goal -- <25% of calories from fat Calorie intake goal kcal/day > 150 minutes per week of physical activity
12 DPPOS Treatment Protocols (Sept 2002 to present) Original Placebo group HELP classes four times a year Original Metformin group HELP classes four times a year Metformin 850 mg twice daily Original Lifestyle group HELP classes four times a year BOOST lifestyle classes twice a year
13 Preventing Diabetes: What Do We Know from the DPP and DPPOS?
14 Cumulative incidence (%) Percent developing diabetes Placebo (n=1082) All participants Metformin (n=1073, p<0.001 vs. Placebo) Lifestyle (n=1079, p<0.001 vs. Met, p<0.001 vs. Plac ) Metformin Lifestyle (n=1079, (n=1073, p<0.001 vs. Metformin, Plac) Placebo (n=1082) p<0.001 vs. Placebo) Risk reduction 31% by metformin 58% by lifestyle DPP Incidence of Diabetes Years from randomization
15 Effect of Treatment on Incidence of Diabetes in the DPP Placebo Metformin Life-style Incidence of diabetes 11.0% 7.8% 4.8% (percent per year) Reduction in incidence % 58% compared with placebo Number needed to treat to prevent 1 case in 3 yrs
16 DPP/DPPOS Incidence of Diabetes Knowler et al. Lancet. 2009; 374: (Figure 3)
17 DPP/DPPOS Incidence of Diabetes Knowler et al. Lancet. 2009; 374: (Figure 3)
18 DPP vs. DPPOS Diabetes Rates Crude Rate per 100 PYR DPP (n=3234) Placebo Metformin Lifestyle DPPOS (n=1994) Knowler et al. Lancet. 2009; 374: (Figure 4)
19 Diabetes Development in DPPOS Original Lifestyle participants continue to develop diabetes at the lower rate they developed diabetes during DPP. Original Placebo and Metformin participants have lowered their rate of diabetes development to a similar rate as the Lifestyle group.
20 Diabetes Risk Reduction in DPPOS Delay in diabetes onset after 10 years follow-up: 4 years for Lifestyle 2 years for Metformin The lower rate of diabetes development for lifestyle and metformin during DPP means: Original Lifestyle participants have a 34% lower risk of diabetes compared to Placebo Original Metformin participants have a 18% lower risk of diabetes compared to Placebo
21 Study Population Caucasian 1768 African-American 645 Hispanic-American 508 Asian-American & Pacific Islander 142 American Indian 171 Total 3234 African American 20% Hispanic 16% Caucasian 55% Asian 4% American Indian 5%
22 DPP Diabetes Incidence Rates by Ethnicity Lifestyle Metformin Placebo Cases/100 person-yr Caucasian (n=1768) African American (n=645) Hispanic (n=508) American Indian (n=171) Asian (n=142)
23 Study Population Age Distribution > 60 20% % %
24 DPP Diabetes Incidence Rates by Age Cases/100 person-yr Lifestyle Metformin Placebo (n=1000) (n=1586) > 60 (n=648) Age (years)
25 Percent with Diabetes by Treatment Group at 10-years 52% of Placebo participants have diabetes 47% of Metformin participants have diabetes 42% of Lifestyle participants have diabetes
26 Hazard Rate for Developing Diabetes As A Function of Weight Change From Baseline Hazard rate per 100/yr Intensive Lifestyle Group Average Risk Hamman Diabetes Care 2006 Mean weight change from baseline (kg)
27 What Contributed to Prevention? Weight loss was the most important predictor of diabetes risk For every 2.2 pounds of weight loss, diabetes risk was reduced 16% Self reported improvements in diet and physical activity that did not result in weight loss did not result in lower diabetes risk Weight loss predicted by lower dietary fat and physical activity More fasting glucoses normalized in ILS group
28 What Contributed to Prevention? (cont.) Persons reporting the lowest % of calories from fat had a greater decrease in risk of diabetes for every kilogram of weight loss For every 5% reduction in percent fat during follow-up, diabetes incidence was reduced by 25% Reduction of >90% for those meeting both goals Success higher in older individuals, higher initial body weight and lower physical activity The effect of weight loss on the risk of diabetes was not modified by age, sex, ethnicity, physical activity
29 Weight Change Over Time Overall Knowler et al. Lancet. 2009; 374: (Figure 2)
30 DPP Changes in Leisure Physical Activity MET-hours/week Lifestyle Metformin Placebo Years from Randomization
31 Physical Activity in the DPP Those not meeting the weight loss goal, but achieving the physical activity goal had 44% lower diabetes incidence Increased physical activity was not associated with initial weight loss, but was significantly related to long term weight loss Exercise is more strongly associated with maintenance of weight loss than with initial weight loss Physical activity does not always decrease with age The most active age group in the DPP was aged 60 and over Physical Activity in Individuals at Risk for Diabetes: Diabetes Prevention Program. Medicine and Science in Sports and Exercise.
32 Lifestyle Intervention Results Results: After Core Curriculum Weight Loss 6.6 kg (14.5 lb) % weight loss 7.0 % % at or above weight loss goal 49.7 % Physical Activity 224 minutes % at or above activity goal 74.4 % At weight goal after 2.8 years 37% At activity goal after 2.8 years 67% The DPP Research Group, NEJM 346: , 2002
33 The DPP Research Group, NEJM 346: , 2002 Change in Weight and Behavior Over Time Intensive Lifestyle Group Mean change at Variable Baseline Year 1 Year 2 Year 3 Weight (kg) BMI (kg/m 2 ) Met-hrs / Week (MAQ) Met-hrs / Week (LoPAR) Total kilocalories / day Total fat / day (grams) % Calories from fat 34.1 % % -- --
34 PPAARGP12A s relation to diabetes Florez et al J Clin Endocrinol Metab 2007
35 Bridge Period between DPP and DPPOS LIFESTYLE participated less than other groups and gained slightly (+1.33 kg on avg) PLAC, MET, and TROG groups lost weight (about 2.3 kg on avg) High attenders (12 to 16 sessions) lost more than low attenders (except for LIFESTYLE) Conclusion simply repeating programs is not effective over time Venditti et al, 2008, Int J Obes; 32:
36 Additional Results Prevention or delay of diabetes within original lifestyle and metformin groups persists for 10 years Original lifestyle participants have a 34% risk reduction in diabetes compared to placebo Original metformin participants have a 18% risk reduction in diabetes compared to placebo
37 Additional Results (2) Lifestyle and metformin treatment resulted in improved blood pressure measurements All groups had decreased cholesterol and triglycerides Lifestyle presented the same or lower blood pressure and lipid levels over time as other groups despite lower use of medication
38 What Was the DPP/DPPOS Lifestyle Balance?
39 Role of the RD in the DPP/DPPOS As a part of the team of researchers Developed Protocol and Manuals of Operations Planned Lifestyle Interventions Implemented interventions, including lifestyle Evaluated the protocol implementation Assisted in translation efforts
40 RDs as Lifestyle Coaches Lifestyle coaches were usually dietitians Met with participants regularly Coordinated and monitored completion of curriculum Planned and implemented post core activities Case Managed followup care as needed and appropriate
41 RDs Role in Retention Tailored intervention for the needs, cultural and otherwise, of the participant Used counseling and rapport building skills to retain participants Assisted in group problem solving
42 RDs Participating in Central Management of the DPP/DPPOS Some Program Coordinators National planning and oversight committees Design and conduct of ancillary studies Participation in and leading writing groups for publications Quality Control planning and monitoring
43 Useful Resources The Diabetes Prevention Program Research Group. The Diabetes Prevention Program (DPP): Description of lifestyle intervention. Diabetes Care Dec;25(12): Hoskin M, Begay S, Bolin P, Hermes J, Ingraham L, Killean T, Nelson J, Percy C, Scurlock N, Shovestull LE, Tomchee C, the Diabetes Prevention Program and Action for Health in Diabetes (Look AHEAD) research groups. Providing lifestyle interventions in American Indian communities. Obesity Management Journal 2005 Dec;1(6): Wylie-Rosette J, Delahanty L. An integral role of the dietitian: Implications of the Diabetes Prevention Program. J Am Diet Assoc Aug;102(8): Delahanty L, Begay S, Cooeyate N, Hoskin M, Isonaga M, Levy E, Mikami K, Ka julani Odom S, Szamos K The effectiveness of Lifestyle Intervention in the Diabetes Prevention Program: Application in Diverse Ethnic Groups On The Cutting Edge Winter 2002;23(6).
44
45 DPP Lifestyle Intervention Structure 16 session core curriculum (over 24 weeks) Long-term maintenance program Supervised by a coach Access to lifestyle support staff Dietitian Behavior counselor Exercise specialist
46 The DPP Core Curriculum Education and training in eating and exercise methods and behavior modification skills Emphasis on: Self monitoring techniques Problem solving Individualizing programs Self esteem, empowerment, and social support Frequent contact with case manager and DPP support staff
47 DPP Post Core Program Self-monitoring and other behavioral strategies Monthly visits Must be seen in person at least every two months Supervised exercise sessions offered Periodic group classes and motivational campaigns Tool box strategies Provide exercise videotapes, pedometers Problem solving
48 In DPP behavioral guidance is integral to every session Let s think about the principles being used in each session
49 Session 1: Welcome to the Lifestyle Balance Program Build commitment Assign weight and exercise goals Review key aspects of relationship with interventionist Begin self-monitoring food intake (Keeping Track, Quick Track) Keeping Track
50 Session 2: Be a Fat Detective Begin self-monitoring weight Assign fat goal (25% calories): 33, 42, 50, or 55 grams/day Begin self-monitoring fat intake (Fat Counter) FAT
51 Daily Fat and Calorie Goals Weight (lbs) Fat Goal (grams) Calorie Goal , , ,800 > ,000 Be a Fat and Calorie Detective
52 Session 3: Three Ways to Eat Less Fat Weigh and measure foods, estimate portions Practice three ways to eat less fat: Eat high-fat foods less often Eat them in smaller amounts Substitute lower-fat foods and cooking methods
53 Session 4: Healthy Eating Eat regular meals and eat slowly Follow the latest Food Pyramid (provided ethnic versions) Choose low-fat, low-calorie items from each Pyramid group
54 Session 5: Move Those Muscles Build to 150 minutes/week over five weeks Begin self-monitoring activity Introduce group activity sessions How to choose footwear
55 Session 6: Being Active: A Way of Life Ways to find time to be active, including short bouts Introduce lifestyle activity (e.g., climbing stairs) Review safety issues related to physical activity
56 Session 7: Tip the Calorie Balance Define energy balance If participant had little progress with weight loss, assign calorie goal, begin self-monitoring calories or following meal plan
57 Session 8: Take Charge of What s Around You Introduce cue control Identify problem cues and ways to avoid, change, or respond differently to them Identify helpful cues and ways to add them
58 Session 9: Problem Solving Describe problem in detail (include behavior chain) Brainstorm possible solutions Pick one to try Make a positive action plan Try it. Keep trying Problems can be solved.
59 Session 10: Four Keys to Healthy Eating Out Ways to manage eating out: Plan ahead Ask for what you want Be firm and friendly Take charge of what s around you Choose foods carefully
60 Session 11: Talk Back to Negative Thoughts Counter common patterns of self-defeating, negative thoughts with positive statements
61 Session 12: The Slippery Slope of Lifestyle Change Slips are normal Learn ways to recover from slips Review personal triggers, reactions, and how to get back on track
62 Session 13: Jump Start Your Activity Plan Add interest and variety Follow the FITT principle of aerobic fitness: frequency, intensity, time, type of activity Measure target heart rate and perceived level of exertion
63 Session 14: Make Social Cues Work for You Manage problem cues in social settings (e.g., being pressured to overeat) Add helpful cues (e.g., bring a low-fat item) Ask for support Plan ahead for social events
64 Session 15: You Can Manage Stress Ways to cope with stress: Take a brief time out to relax Say no. Seek support Solve problems. Plan ahead Talk back to negative thoughts Be physically active
65 Session 16: Ways to Stay Motivated Remember your purpose Recognize your successes Continue to self-monitor Add variety Set new goals and rewards Create friendly competition Seek support
66 DPP After Core Goals Maintain weight loss goals Maintain activity goals See participants in person every two months Most participants desired monthly contact Phone contact between visits Three group sessions per year Nutrition, activity, behavior
67 Motivational Campaigns in DPP (2-3 per year) Key features Make a commitment for 4-8 weeks Be part of a team Return to the basics Receive reward and recognition Goal driven, incentive based Group based
68 What were the Keys to Success? Lessons we are learning from the Diabetes Prevention Program and Outcomes Study
69 Keys to Success Clearly defined and achievable goals and expectations Case management approach Frequent contact Relationships- staff and family Intensive, ongoing intervention Individualization Materials and strategies that addressed the needs of an ethnically diverse population Keeping track Provide tools to achieve goals
70 Defined and Achievable Goals Individualized fat and calorie goals for weight loss Individual weight loss goal (7%) Physical Activity goal of 150 min per wk Time frame to meet stated goals Participant contracts
71 Case Management Consistent relationships Work with the participant as a team Hang in there- reinforcement Be supportive Utilize multidisciplinary approach
72 Health Coaching Model The health coaching model uses a team of health professionals to assist patients in making behavior changes to improve their health. An assigned health coach works with the patient and multi-disciplinary team to work collaboratively with the patient to create a health plan by helping them to identify barriers and establish goals to change health related behaviors.
73 Characteristics of a Health Coach and Participant Relationship Building Trust Facilitating Change Valuing Diversity Communication Gaining Commitment Problem Solving Revisiting and Adjusting Building on Success
74 Who Could be a Coach? Professionals were used in the DPP Paraprofessional helped support Implementation in American Indian communities have used both The coach needs to be supported by a team
75 Consistency Supportive Honest Believe in you Family Relationships
76 Frequent Contact Weekly Monthly Campaigns/Maintenance Most chose to come in more often
77 Intensive, Ongoing Intervention Continued self-monitoring and other behavioral strategies Frequent contact Group classes and motivational campaigns Tool box strategies
78 Individualization Goals individualized to starting weight and what makes them successfully lose weight Recipes and menus Interpersonal and individual needs like jobs, literacy and language Team approach they choose how
79 Targeting for Population Use local examples to reinforce points 3 ways to eat less fat Recipes and Foods Designed for use in many different ethnic groups Physical Activity
80 Strategies to Address Ethnic/Demographic Diversity Community personnel Materials adapted for ethnic/regional diversity Simplified self-monitoring tools Local centers choose/adapt supplemental classes
81 Tool Box: Problem Solving Dominates
82 What did DPP coaches do with most participants (for weight)? Top Approaches Used to Improve Weight Loss CORE POST- CORE Problem-Solving (review behavior chains/action plans) 77% 96% Review Self-Monitoring Skills 49% 76% Recommend Increased Activity 35% 76% Recommend Lower Fat/Cal Goal 24% 25% Schedule Extra Phone Call or Visit 18% 75% New Self-Monitoring Strategy 16% 47% Provide Healthy Recipes 14% 37% Motivational Strategy (No Cost) 13% 25% Motivational Strategy (Added Cost) 11% 52% Recommended Meal Plans 10% 40% Mailings; Recommend or Provide Slim Fast; Refer to Specialists; Involve Family; Provide Lower Fat/Cal Frozen Entrees, Taste Testings, Cookbooks/Utensils <10% 0-30%
83 What did DPP coaches do with most participants (for activity)? Top Approaches Used to Improve Physical Activity CORE POST- CORE Problem-Solving (review behavior chains/action plans) 74% 91% Coach Exercises With Participant 18% 48% Schedule Extra Phone Call or Visit 16% 64% Motivational Strategy (No Cost) 14% 24% Recommend Exercise Facility (No Cost) 10% 19% Refer to Exercise Specialist (No Cost) 10% 22% Make Plan to Find Exercise Partner 9% 24% Motivational Strategy (Added Cost) 8% 44% Loaned Item to Support PA 8% 18% Purchase Item to Support PA (Cost) 8% 26% Provide Trial Health Club Membership 6% 14% Gave Pedometer (Cost) 3% 41% Mailings, Register for Activity Events, Recommend New Self-Monitoring Tool, Involve Family <5% 0-30%
84 Motivational Interviewing in Health Care Guide Direct Follow Rollnick S, Mason P, Butler C. Motivational interviewing in health care: helping patients change behavior. Guilford Press, 2008.
85 Services-Research Continuum Identify problems and research questions Health Services Research Study Improve practice and standards of care
86 Implementation in our Communities YMCA Model Group Lifestyle Balance Model Small Steps Model Others Montana, Indian Health Service
87 Without the generous participation of the DPP/DPPOS participants, none of this information would be available.
88 Website for DPP lifestyle manuals, publications, and other information
89 SMALL STEPS BIG REWARDS
90 The risk is great.
91 The goals are important
92 The changes are modest.
93 The action steps are clear.
94 That doesn t make it easy for you, but the DPP demonstrated that it can be done. NIH Pub. No Feb 2003
95 THANK YOU
The Diabetes Prevention Program's Lifestyle Change Program. Participant Notebook
The Diabetes Prevention Program's Lifestyle Change Program Participant Notebook The Diabetes Prevention Program's Lifestyle Change Program Your name: Your Lifestyle Coach is Address: Phone: Session 1A:
More informationPreventing Diabetes K A R O L E. W A T S O N, M D, P H D, F A C C P R O F E S S O R O F M E D I C I N E / C A R D I O L O G Y
Preventing Diabetes 2018 K A R O L E. W A T S O N, M D, P H D, F A C C P R O F E S S O R O F M E D I C I N E / C A R D I O L O G Y D A V I D G E F F E N S C H O O L O F M E D I C I N E A T U C L A CO-DIRECTOR,
More informationSession 0A: Welcome to the Look AHEAD Lifestyle Program. Session 0B: Welcome to the Look AHEAD Lifestyle Program
Look AHEAD Program All sessions include a weigh in and homework review at the beginning of the session. Starting with session 8, muscle stretches and exercises are included at the close of each session.
More informationHarold Schnitzer Diabetes Health Center. Finally Some Good News About Diabetes- Delaying/Preventing Diabetes in Those at High Risk!
Harold Schnitzer Diabetes Health Center Finally Some Good News About Diabetes- Delaying/Preventing Diabetes in Those at High Risk! If Only It Was This Easy. Activity Diet Nation Objectives At the End of
More informationSession 14: Take Charge of Your Lifestyle
Session 14: Take Charge of Your Lifestyle In GLB, you have learned: 1. Many facts about healthy eating and being more physically active. 2. What makes it hard to change long-standing lifestyle behaviors.
More informationJ. Michael Gonzalez-Campoy, MD, PhD, FACE Teresa Pearson, MS, RN, CDE, FAADE
SCREEN, COUNSEL, REFER AND FOLLOW-UP FOR DIABETES AND PREDIABETES J. Michael Gonzalez-Campoy, MD, PhD, FACE drmike@mncome.com Teresa Pearson, MS, RN, CDE, FAADE tpearson@hallelandhabicht.net Sponsored
More informationHow do we adapt diet approaches for patients with obesity with or without diabetes? Therese Coleman Dietitian
How do we adapt diet approaches for patients with obesity with or without diabetes? Therese Coleman Dietitian Developing a specialist weight management programme How did we adapt dietary approaches for
More informationAm I at Risk for Type 2 Diabetes?
Am I at Risk for Type Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes On this page: What is type diabetes? Can type diabetes be prevented? What are the signs and symptoms of type diabetes?
More informationThe National Diabetes Prevention Program in Washington State March 2012
The National Diabetes Prevention Program in Washington State March 2012 Session Objectives 1. Overview of pre-diabetes. 2. Describe the Diabetes Prevention Program (DPP). 3. Eligibility for the DPP. 4.
More informationCommunity Partnerships on Obesity & Diabetes
Community Partnerships on Obesity & Diabetes Puni Kekauoha, PILI Ohana Project Claire Townsend, DrPH, Department of Native Hawaiian Health He Huliau September 12, 2015 Community-Based Participatory Research
More informationAm I at Risk for Type 2 Diabetes?
NATIONAL DIABETES INFORMATION CLEARINGHOUSE Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes U.S. Department of Health and Human Services National Institutes of Health
More informationDIABETES PREVENTION PROGRAM
DIABETES PREVENTION PROGRAM The YMCA s Diabetes Prevention Program is a one-year, community-based program where participants work in small groups with a trained Lifestyle Coach in a relaxed, classroom
More informationInnovate. Discover. Cure. Type 2 Diabetes what you and your family need to know
1 Innovate. Discover. Cure. Type 2 Diabetes what you and your family need to know Opening comments Steven R. Smith, MD Founding Scientific Director - TRI Professor, metabolic diseases program, Sanford-Burnham
More informationInnovative Approaches to Implementing the National Diabetes Prevention Program
Innovative Approaches to Implementing the National Diabetes Prevention Program Julissa Soto Region Director Community Health Strategies Monica Chavez-Singleton, Senior Manager Program Graduate lost 52lbs
More informationJennifer Janetski, MS RD CDE
Jennifer Janetski, MS RD CDE Is there a need for Diabetes Prevention? World s fifth leading cause of death in 2000. Diabetes Care, 2005 24.1 million Americans have diabetes and it is projected to double
More informationWELL-WOMAN EXAM REVEALS RISK. Katie Jones, MPH, CHES Iowa Department of Public Health Erin Hinderaker, MS, RD, LD Des Moines University
WELL-WOMAN EXAM REVEALS RISK Katie Jones, MPH, CHES Iowa Department of Public Health Erin Hinderaker, MS, RD, LD Des Moines University Disclaimer The information provided in this presentation is for informational
More informationPromising Practices in Nutrition and Diabetes Prevention and Management Special Diabetes Programs for Indians (SDPI) in Tucson, AZ
Promising Practices in Nutrition and Diabetes Prevention and Management Special Diabetes Programs for Indians (SDPI) in Tucson, AZ Presented by the Western Region Public Health Training Center & Southwest
More informationTranslation of the Diabetes Prevention Program: the U.S. National Diabetes Prevention Program
Translation of the Diabetes Prevention Program: the U.S. National Diabetes Prevention Program Kris Ernst, RN, CDE Division of Diabetes Translation Centers for Disease Control and Prevention kce0@cdc.gov
More informationYES!!!! Is there a need for Diabetes Prevention? 5/28/ obesity prevalence 25% in 30 states and 20% in 49 states
Jennifer Janetski, MS RD CDE Is there a need for Diabetes Prevention? World s fifth leading cause of death in 2000. Diabetes Care, 2005 24.1 million Americans have diabetes and it is projected to double
More informationDiabetes Prevention in. Massachusetts: Prediabetes and the Diabetes Prevention Program. Diabetes Prevention and Control
Diabetes Prevention in r Massachusetts: Prediabetes and the Diabetes Prevention Program Diabetes Prevention and Control www.mass.gov/dph/diabetes Massachusetts Department of Public Health 29 million with
More informationDonna Tomky, MSN, C-ANP, CDE, FAADE Albuquerque, New Mexico
Donna Tomky, MSN, C-ANP, CDE, FAADE Albuquerque, New Mexico Presented in Collaboration with New Mexico Health Care Takes On Diabetes Discuss the burden and challenges prediabetes presents in New Mexico.
More informationAm I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes
Nat i o N a l Diabetes inf o r m a t i o N Cle a r i N g h o u s e Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes U.S. Department of Health and Human Services NATIONAL
More informationAm I at Risk for Type 2 Diabetes?
Page 1 of 8 Am I at Risk for Type 2 Diabetes? Taking Steps to Lower Your Risk of Getting Diabetes On this page: What is type 2 diabetes? Can type 2 diabetes be prevented? What are the signs and symptoms
More informationPrediabetes 101. What is it and what can I do about it? Intermountainhealthcare.org/diabetes
Prediabetes 101 What is it and what can I do about it? Patient Education Intermountainhealthcare.org/diabetes What do you already know about prediabetes? Fact or Fiction? There are often no symptoms of
More informationNational Diabetes Prevention Program. Lifestyle Change Program
National Diabetes Prevention Program Lifestyle Change Program NDPP CDC-recognized lifestyle change programs are based on years of research showing that a year-long, structured lifestyle change intervention
More informationMedicare Diabetes Prevention Program
Medicare Diabetes Prevention Program Overview of Proposed Rule in CY 2017 Medicare Physician Fee Schedule August 9, 2016 A few logistics before we start Please confirm if you can hear us. When the poll
More informationGoals of today s talk. How to Stop Prediabetes from Becoming Diabetes. Goals of today s talk. Type 2 diabetes mellitus
Goals of today s talk How to Stop Prediabetes from Becoming Diabetes Zara Frankel, MD Boulder Creek Family Medicine 303-720-6956 Diabetes is a devastating disease Prediabetes and diabetes are on different
More informationHealthy Rewards Program Calendar
Healthy Rewards Program Calendar May 2015 These programs are open to all Saint Francis Medical Center employees and volunteers. Full-time and part-time employees enrolled in the Healthy Rewards Employee
More informationIt s Never Too Early To Prevent Diabetes: The Lasting Impact of Gestational Diabetes on Mothers and Children
It s Never Too Early To Prevent Diabetes: The Lasting Impact of Gestational Diabetes on Mothers and Children Robert Ratner, M.D., F.A.C.P. Vice President for Scientific Affairs, Medstar Research Institute
More informationReady, Set Take Action!
Ready, Set Take Action! Sign up now for your 2017 Take Action activity. ra.staywell.com Make Your Health a Priority in 2017 A new year means a new opportunity to build healthy habits and live your best
More informationHEALTH EDUCATION PROGRAMS. Dedicated to Your Lifelong Wellness. Health Plan of Nevada Sierra Health and Life
HEALTH EDUCATION PROGRAMS Dedicated to Your Lifelong Wellness Health Plan of Nevada Sierra Health and Life HEALTH EDUCATION AND WELLNESS A Team Approach to Good Health Education is an important part of
More informationDiagnosis of Diabetes National Diabetes Information Clearinghouse
Diagnosis of Diabetes National Diabetes Information Clearinghouse National Institute of Diabetes and Digestive and Kidney Diseases NATIONAL INSTITUTES OF HEALTH U.S. Department of Health and Human Services
More informationImplementing Type 2 Diabetes Prevention Programmes
Implementing Type 2 Diabetes Prevention Programmes Jaakko Tuomilehto Department of Public Health University of Helsinki Helsinki, Finland FIN-D2D Survey 2004 Prevalence of previously diagnosed and screen-detected
More informationWeight Management Phase Two. Lesson Six
Weight Management Phase Two Lesson Six Long-Term Change Objectives: Learn how to change habits for longterm success Learn how to commit for long-term change Key Elements of Weight Management Goals of long-term
More informationQuick Fact: How do I stay engaged after Scale Back Alabama is over?
Ways to Stay Motivated Scale Back Alabama Congratulations! This is the end of this year's program. You now have the tools and information to continue your journey toward a healthier lifestyle. Continue
More informationSpecific treatment for obesity will be determined by your health care provider based on:
Regardless of the type or combination of obesity treatment, goal setting is an important part of any obesity treatment plan. While a person may want to lose a large amount of weight because of societal
More informationMonthly Campaign Webinar November 15, 2018
Monthly Campaign Webinar November 15, 2018 2 Today s Webinar Together 2 Goal Updates Webinar Reminders National Day of Action Diabetes Bundle Collaborative Diabetes Prevention Program Q&A Tony Hampton,
More informationSession 21 Leader Guide: Heart Health
Session 21 Leader Guide: Heart Health Objectives In this session, the participants will: Identify the leading cause of death in American adults. Define heart disease. Learn the risk factors for heart disease.
More informationHealthy Rewards Program Calendar SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY am Heart & Health Screening
Healthy Rewards Program Calendar September 2018 These programs are open to all Saint Francis Healthcare System employees and volunteers. Full-time and part-time employees enrolled in Healthy Rewards Employee
More informationThe Prevention of Type 2 Diabetes: From Theory to Practice
The Prevention of Type 2 Diabetes: From Theory to Practice David G Marrero, Ph.D. J.O. Ritchey Professor of Medicine Diabetes Translational Research Center Indiana University School of Medicine Diabetes:
More informationAn Opportunity for Community Health Workers April, 2018
An Opportunity for Community Health Workers April, 2018 Prevalence of diabetes and prediabetes CDC-recognized Diabetes Prevention Programs in Missouri Take It Back campaign YMCA s Diabetes Prevention Program
More informationWhy Screen at 23? What can YOU do?
Why Screen at 23? Every 1 in 2 Asian American adults has diabetes or prediabetes. More than half of Asian Americans did not know they have type 2 diabetes or prediabetes. Asian Americans can develop diabetes
More informationMonthly WellPATH Spotlight November 2016: Diabetes
Monthly WellPATH Spotlight November 2016: Diabetes DIABETES RISK FACTORS & SELF CARE TIPS Diabetes is a condition in which the body does not produce enough insulin or does not use the insulin produced
More informationPrevent Diabetes STAT Hannah Herold, MPH, MA, CHES Chronic Disease Prevention Program Wyoming Department of Health Partnering with Wyoming Primary
Prevent Diabetes STAT Hannah Herold, MPH, MA, CHES Chronic Disease Prevention Program Wyoming Department of Health Partnering with Wyoming Primary Care Association Objectives Understand the prevalence
More informationManual for Contacts after Core
The Diabetes Prevention Program's Lifestyle Change Program Manual for Contacts after Core Copyright 1997 by the University of Pittsburgh. Developed by the Diabetes Prevention Program Lifestyle Resource
More informationPrediabetes. Clinical Health Education. 7/1//2014 Chronic Conditions Management Department
Prediabetes Clinical Health Education 7/1//2014 Chronic Conditions Management Department What are your concerns about having prediabetes? What are you doing to address these concerns? 2 People with prediabetes
More informationEatRight TM Lifestyle Program. EatRight TM Weight Maintenance Program. EatRight TM Worksite Wellness Programs. UAB Risk Reduction Clinic
s s s s s TM Lifestyle Program TM Weight Maintenance Program TM Worksite Wellness Programs UAB Risk Reduction Clinic TM OPTIFAST TM Program UAB Health System TM 1-205-934-7053 www.eatright.uab.edu Welcome
More informationSession 14: Overview. Quick Fact. Session 14: Make Social Cues Work for You. The Power of Social Cues. Dealing with Social Cues
Session 14: Overview The Power of Social Cues Social cues are occasions that trigger us to behave in a certain way when we re around other people. For example, watching a football game with friends is
More informationDisclosure Statement
Part 5 PROMOTING NUTRITIONAL HEALTH AND DIABETES PREVENTION Presented by: Katherine Brieger, RD and Elizabeth Magenheimer, MSN, APRN,CNM Disclosure Statement Faculty: Katherine Brieger, RD and Elizabeth
More informationUNIT ONE LESSON 3 OUTLINE
UNIT ONE LESSON 3 OUTLINE Welcome participants and ask how they are doing supporting each other. Remind them: When a person has diabetes their blood glucose level is too high. Taking part in physical activity
More informationChoosing Life: Empowerment, Action, Results! CLEAR Menu Sessions. Substance Use Risk 2: What Are My External Drug and Alcohol Triggers?
Choosing Life: Empowerment, Action, Results! CLEAR Menu Sessions Substance Use Risk 2: What Are My External Drug and Alcohol Triggers? This page intentionally left blank. What Are My External Drug and
More information16 WEEKS TO A HEALTHIER YOU
16 WEEKS TO A HEALTHIER YOU Anthem Blue Cross of California is introducing a new benefit called the Diabetes Prevention Program (DPP). The DPP is available as a covered, preventive benefit to all Anthem
More informationDiabetes Prevention Action Plan Iowa Department of Public Health Protecting and Improving the Health of Iowans
Diabetes Prevention Action Plan Iowa Department of Public Health Protecting and Improving the Health of Iowans Introduction Andrew Minear, MPH Diabetes Primary Prevention Coordinator Phone: 515-725-2839
More informationImproving the Odds of Success through Motivational Interviewing
Disclosure Information Western Occupational Health Conference 2011 Robert Scales, Ph.D. I have no financial relationships to disclose I will not discuss off label use and/or investigational use in my presentation
More informationTranslational Science in the Behavioral Domain: More interventions please... but enough with the efficacy! Paul A. Estabrooks, PhD
Translational Science in the Behavioral Domain: More interventions please... but enough with the efficacy! Paul A. Estabrooks, PhD Disclosures Financial: Carilion Clinic Scientific Biases: Efficacy trials
More informationUNIT THREE LESSON 9 OUTLINE
UNIT THREE LESSON 9 OUTLINE Welcome participants to the final lesson in Unit Three. Find out how they are doing in terms of counting carbohydrates as learned in Lesson 8. Read and briefly describe objectives
More informationSession 4 or 2: Be a Fat Detective.
Session 4 or 2: Be a Fat Detective. We ll begin today to keep track of your weight. Your starting weight was Your weight goal is pounds. pounds. To keep track of your weight: At every session, mark it
More informationAmy Rothberg, MD, PhD Andrew Kraftson, MD Nevin Ajluni, MD Carol Catalano PA-C Catherine Nay, MEd, RD, CHES Megan Brown, MPH, RD Nicole Miller, MPH,
Amy Rothberg, MD, PhD Andrew Kraftson, MD Nevin Ajluni, MD Carol Catalano PA-C Catherine Nay, MEd, RD, CHES Megan Brown, MPH, RD Nicole Miller, MPH, RD What is it? Behavioral lifestyle program. 100 week
More informationMonitoring Physical Activity in a Form that is Meaningful for Patients and Providers Enrolled in a Weight Management Program
Monitoring Physical Activity in a Form that is Meaningful for Patients and Providers Enrolled in a Weight Management Program Joseph E. Donnelly, ED.D., FACSM, FTOS Professor, Internal Medicine Director,
More informationPersonal Fitness Plan [Type the document subtitle] 3/10/2014 Class Period MW T/TH
Personal Fitness Plan [Type the document subtitle] 3/10/2014 Class Period MW T/TH MY PERSONAL FITNESS PLAN CONTRACT Fitness Contract for Self I,, am going to make a commitment to helping build lifelong
More informationNational Diabetes Prevention Program Centers for Medicare & Medicaid Service Expansion. Tribal Leaders Diabetes Committee September 22, 2016
National Diabetes Prevention Program Centers for Medicare & Medicaid Service Expansion Tribal Leaders Diabetes Committee September 22, 2016 National Diabetes Prevention Program (DPP) Lifestyle change program
More informationMercy Diabetes Prevention Program
Mercy Diabetes Prevention Program Know the risk. Make the change. Live your life. Ashton Caton, Community Wellness Program Manager May 11, 2018 The Statistics DIABETES 30.3 million Americans People who
More informationEducation and Lifestyle
Education and Lifestyle Provide strategies to incorporate patient education into diabetes selfmanagement Develop plans to involve other healthcare professionals to support the care of patients with type
More informationGEORGE MASON UNIVERSITY School of Recreation, Health, and Tourism. PHED 105 Aerobics and Basic Conditioning
GEORGE MASON UNIVERSITY School of Recreation, Health, and Tourism PHED 105 Aerobics and Basic Conditioning Fall 2012 Ethan Carter ecarter8@gmu.edu (703) 993-3935 TABLE OF CONTENTS Overview.3-4 Tentative
More informationDiabetes Care begins with Diabetes Prevention. Neha Sachdev, MD Janet Williams, MA
Diabetes Care begins with Diabetes Prevention Neha Sachdev, MD Janet Williams, MA Objectives Describe the clinical practice burden and trends in type 2 diabetes Review evidence for diabetes prevention
More informationBENEFITS OF RECRUITING PARTICIPANTS WITH FRIENDS AND INCREASING SOCIAL SUPPORT FOR WEIGHT LOSS AND MAINTENANCE
BENEFITS OF RECRUITING PARTICIPANTS WITH FRIENDS AND INCREASING SOCIAL SUPPORT FOR WEIGHT LOSS AND MAINTENANCE Rena R. Wing University of Pittsburgh School of Medicine Robert W. Jeffery University of Minnesota
More informationOnline Nutrition Counseling
Online Nutrition Counseling Participant Guide Introduction to Part 2 Online Nutrition Counseling Part 2 1 Welcome to Part 2 Welcome to the Online Nutrition Counseling program Part 2. This part of the lifestyle
More informationHealthy Rewards Program Calendar
Healthy Rewards Program Calendar January 2015 These programs are open to all Saint Francis Medical Center employees and volunteers. Full-time and part-time employees enrolled in the Healthy Rewards Employee
More informationLessons from conducting research in an American Indian community: The Pima Indians of Arizona
Lessons from conducting research in an American Indian community: The Pima Indians of Arizona Peter H. Bennett, M.B., F.R.C.P. Scientist Emeritus National Institute of Diabetes and Digestive and Kidney
More informationObesity Prevention and Control: Provider Education with Patient Intervention
Obesity Prevention and : Provider Education with Patient Summary Evidence Table and Population Cohen et al. (1991) 1987-1988 : RCT Location: Pittsburgh, PA Physician training session by a behavioral psychologist
More informationAim: 15kg or 2½ stone or 33lb weight loss
-PLUS A NON SURGICAL WEIGHT MANAGEMENT SOLUTION Aim: 15kg or 2½ stone or 33lb weight loss for people with a Body Mass Index (BMI) 28kg/m 2 with Type 2 diabetes OR a BMI 30kg/m 2 (BMI is a common way to
More informationDiabetes Prevention. UCSF Internal Medicine Updates San Francisco May, 2018
Diabetes Prevention UCSF Internal Medicine Updates San Francisco May, 2018 Elizabeth J. Murphy, MD, DPhil Professor of Clinical Medicine Deborah Cowan Endowed Professorship in Endocrinology University
More informationDiabetes Care begins with Diabetes Prevention. Neha Sachdev, MD Janet Williams, MA
Diabetes Care begins with Diabetes Prevention Neha Sachdev, MD Janet Williams, MA Objectives Describe the clinical practice burden and trends in type 2 diabetes Review evidence for diabetes prevention
More informationSupport for Community Sport. Scottish Canoe Association. Question 1: What is being done to support volunteers in community sport?
CS040 Support for Community Sport Scottish Canoe Association Question 1: What is being done to support volunteers in community sport? The SCA is a volunteer-led organisation and most organised canoeing
More informationThe Activity Spectrum Falling Out of Balance
Physical Activity and Inactivity in Individuals with Pre-Diabetes Physical Activity/Nutrition/Sedentary Time Andrea M. Kriska, PhD AADE5 New Orleans, LA August 5 -, 5 Effect of Westernization on Health;
More informationInspiring and Supporting Behavior Change
Inspiring and Supporting Behavior Change A Food, Nutrition, and Health Professional s Counseling Guide Second Edition Cecilia Sauter, MS, RD, CDE, FAADE Ann Constance, MA, RD, CDE, FAADE Contents Foreword...vii
More informationChoosing Life: Empowerment, Action, Results! CLEAR Menu Sessions. Health Care 3: Partnering In My Care and Treatment
Choosing Life: Empowerment, Action, Results! CLEAR Menu Sessions Health Care 3: Partnering In My Care and Treatment This page intentionally left blank. Session Aims: Partnering In My Care and Treatment
More informationLesson 1: Making and Continuing Change: A Personal Investment
Lesson 1: Making and Continuing Change: A Personal Investment Introduction This lesson is a review of the learning that took place in Grade 11 Active Healthy Lifestyles. Students spend some time reviewing
More informationLiving Well with Diabetes
Living Well with Diabetes What is diabetes? Diabetes Overview Diabetes is a disorder of the way the body uses food for growth and energy. Most of the food people eat is broken down into glucose, the form
More informationInterdisciplinary Certification in Obesity and Weight Management Detailed Content Outline
1. Patient Assessment and Development of Treatment Plan (35 Items) A. Patient History and Current Status 1. Collect patient assessment information: a. weight history, including development genetics growth
More informationKCAS Health, Nutrition 2.31, 3.2, 3.5 Health, Psychomotor Skills 2.31, 2.35 Health, Safety 5.1
KCAS Health, Nutrition 2.31, 3.2, 3.5 Health, Psychomotor Skills 2.31, 2.35 Health, Safety 5.1 1. Preprogram Evaluation Tools (Use only EFNEP approved evaluation tools) 2. Interest Approach Ask one or
More informationHealthy Rewards Program Calendar
Healthy Rewards Program Calendar September 2014 These programs are open to all Saint Francis Medical Center employees and volunteers. Full-time and part-time employees enrolled in the Healthy Rewards Employee
More informationImplications of The LookAHEAD Trial: Is Weight Loss Beneficial for Patients with Diabetes?
Implications of The LookAHEAD Trial: Is Weight Loss Beneficial for Patients with Diabetes? Boston, MA November 7, 213 Edward S. Horton, MD Professor of Medicine Harvard Medical School Senior Investigator
More informationTreating Type 2 Diabetes by Treating Obesity. Vijaya Surampudi, MD, MS Assistant Professor of Medicine Center for Human Nutrition
Treating Type 2 Diabetes by Treating Obesity Vijaya Surampudi, MD, MS Assistant Professor of Medicine Center for Human Nutrition 2 Center Stage Obesity is currently an epidemic in the United States, with
More informationCompetitive Positioning
Competitive Positioning Competitors analysed Desk research of weight loss drink providers in the Australian market was conducted, examining the information published on their websites about products comparative
More informationVIDEO WORKSHEET. Review: # Name: Hour: After viewing each segment, answer the following questions. Making Family Meals Happen
#300008 Name: Hour: VIDEO WORKSHEET Review: After viewing each segment, answer the following questions. Making Family Meals Happen 1. What is one of the most important keys to feeding well? 2. Children
More informationThe Compelling Case for Corporate Weight Loss
The Compelling Case for Corporate Weight Loss Table Of Contents Summary 2 Introduction 3 Program Methods 4 Participants 4 Program Description 4 Data Collection and Statistical Analyses 4 Program Results
More informationWhat s New in the Standards of Medical Care in Diabetes? Dr. Jason Kruse, DO Broadlawns Medical Center
What s New in the Standards of Medical Care in Diabetes? Dr. Jason Kruse, DO Broadlawns Medical Center Learning Objectives By the end of this presentation, participants should be able to: Discuss updates
More informationHow to treat your weight problem
Behavioral changes for losing weight Changing your behaviors or habits related to food and physical activity is important for losing weight. The first step is to understand which habits lead you to overeat
More informationBlood pressure and kidney disease
Blood pressure and High blood pressure is the second most common cause of. Your heart pumps your blood through tubes (blood vessels) called arteries and veins. When your blood moves through the blood vessels,
More informationEducation that supports your health and your life
Alberta Healthy Living Program Education that supports your health and your life Central Zone Winter 2018 Workshop Guide The Alberta Healthy Living Program (AHLP) offers free workshops and one-on-one sessions
More informationWell-Being Data Update. December 14, 2017 Stephanie Fisher, Well-Being Manager
Well-Being Data Update December 14, 2017 Stephanie Fisher, Well-Being Manager Well-Being Score Research In 2014, we selected the Well-Being Assessment based on the extensive research that demonstrated
More informationChoosing Life: Empowerment, Action, Results! CLEAR Menu Sessions. Substance Use Risk 5: Drugs, Alcohol, and HIV
Choosing Life: Empowerment, Action, Results! CLEAR Menu Sessions Substance Use Risk 5: This page intentionally left blank. Session Aims: (70 Minutes) To understand the health consequences of drugs and
More informationDiabetes Education Programs
Wayne HealthCare Greenville, OH 45331 Diabetes Education Programs (937) 547-5750 Corporate Wellness (937) 547-7409 Diabetes Education Programs A resource guide to help individuals manage diabetes. What
More informationSTATE OF THE STATE: TYPE II DIABETES
STATE OF THE STATE: TYPE II DIABETES HENRY DRISCOLL, MD, CHIEF of ENDOCRINOLOGY MARSHALL U, CHERTOW DIABETES CENTER, HUNTINGTON VAMC HEATHER VENOY, RD, LD, CDE DIETITIAN, DIABETES EDUCATOR, CHERTOW DIABETES
More informationThe prevalence of obesity in adults has doubled over the past 30 years
Obesity in America: Facts and Fiction MICHAEL G. PERRI, PhD Professor, Clinical and Health Psychology Interim Dean, College of Public Health and Health Professions University of Florida Overview: Key Questions
More informationInvesting in Diabetes Prevention The National Diabetes Prevention Program and ROI as a covered benefit
Investing in Diabetes Prevention The National Diabetes Prevention Program and ROI as a covered benefit Shannon Haffey, Director of Value Based Benefit & Reimbursement February 2016 Objectives Learn the
More informationMyPlate, MyWins for Kids
MyPlate, MyWins for Kids Brooke Hardison, MPH Director of Nutrition Marketing and Communications USDA Center for Nutrition Policy and Promotion Audiovisual Sponsor Under Secretary Food, Nutrition, and
More informationA NEW WAY TO A NEW YOU! Are you ready to feel fit, energized and healthy?
SM Healthier just got easier A NEW WAY TO A NEW YOU! Are you ready to feel fit, energized and healthy? Then you re ready to LIVE LIFE WELL CentraState Health s powerful new way to improve your health and
More informationTip the Calorie Balance
: Tip the Calorie Balance The Program involves 2 lifestyle changes: 1. Healthy eating. This includes eating less fat and more whole grains, fruits, and vegetables. 2. Being active. Both relate to weight
More information